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目的探讨rt-PA静脉溶栓在急性超早期脑梗死治疗中应用的临床效果。方法选取2013年6月—2014年6月收治的106例急性超早期脑梗死患者作为研究对象,随机分为对照组和观察组各53例。对照组采取常规治疗,观察组在常规治疗基础上联合rt-PA静脉溶栓治疗。对比两组患者治疗前后的国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)、Barthel指数(BL)、简化Fugl-Meyer运动评分(FMA)、改良Ashworth量表(MAS)及出血、再灌注损伤、再闭塞、死亡发生情况,评价临床治疗的安全性。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗后,观察组BL、简化FMA、MAS得分分别为(70.5±22.6)、(79.8±25.3)、(58.7±6.8)分,均显著高于对照组的(56.4±17.4)、(63.6±13.4)、(38.5±10.5)分,观察组NIHSS评分为(1.1±0.5)分,显著低于对照组的(6.3±2.9)分,差异均有统计学意义(均P<0.05)。观察组患者再灌注损伤率、再闭塞率分别为3.77%、3.77%,均显著低于对照组的16.98%、16.98%,差异均有统计学意义(均P<0.05)。结论 rt-PA静脉溶栓治疗急性超早期脑梗死效果确切,可显著改善患者的肢体活动功能、恢复缺损的神经功能、缓解肢体痉挛及提高生活质量,治疗安全性高,具有临床可行性。
Objective To investigate the clinical effect of rt-PA intravenous thrombolysis in the treatment of acute ultra-early cerebral infarction. Methods A total of 106 patients with acute ultra-early cerebral infarction who were admitted to our hospital from June 2013 to June 2014 were randomly divided into control group and observation group (53 cases each). Control group to take conventional treatment, the observation group on the basis of conventional treatment combined with rt-PA intravenous thrombolytic therapy. The National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BL), Simplified Fugl-Meyer Movement Score (FMA), Modified Ashworth Scale (MAS) and Bleeding were compared between the two groups before and after treatment , Reperfusion injury, reocclusion, the incidence of death, evaluate the safety of clinical treatment. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results After treatment, the scores of BL, FMA and MAS in the observation group were (70.5 ± 22.6), (79.8 ± 25.3) and (58.7 ± 6.8) points respectively, which were significantly higher than those in the control group (56.4 ± 17.4 and 63.6 ± 13.4) and (38.5 ± 10.5) points respectively. The NIHSS score of the observation group was (1.1 ± 0.5) points, which was significantly lower than that of the control group (6.3 ± 2.9) points (all P <0.05). The reperfusion injury rate and reocclusion rate in observation group were 3.77% and 3.77%, respectively, which were significantly lower than those in control group (16.98% and 16.98%, both P <0.05). Conclusion rt-PA intravenous thrombolysis is effective in treating acute ultra-early cerebral infarction. It can significantly improve limb mobility, restore neurological deficits, relieve limb spasm and improve quality of life. It is safe and has clinical feasibility.